Identifying rural health and healthcare priorities to guide research and optimize health care – informed by consumers, health professionals and researchers.

Abstract

Background/aim: Achieving the Australian Government’s vision for improved healthcare provision and health outcomes in rural areas requires a strong culture of research in rural health services. Health research often lacks practical relevance or implementation feasibility, and may not address consumer priorities. These evidencepractice gaps have been created, in part, by a “two communities model of knowledge production in which the producers and users of research occupy separate worlds.” Academic researchers often have different objectives and priorities from those who will deliver or use the health services, and consumers and clinicians generally have little involvement in deciding which health issues are the most important to research. Aim is to identify actionable health priorities relevant to stakeholders in the Grampians region. Population/setting: Five rural and regional communities in the Grampians region. Methods: The project consisted of: surveys and community forums to identify community members’ and health professionals’ perceptions of healthcare gaps and local health issues; focus groups with health professionals and community members to identify core values considered important in determining health care priorities; a concept mapping process where community members, health professionals and researchers grouped and rated the health issue statements using the priority-setting criteria. Results: Over 400 health issue statements from three community forums and 187 survey respondents (70 health professionals, 117 community members) were synthesised into 72 unique statements. Three key values were identified as important for priority setting: (1) health equity; (2) capacity to address the health issue; and (3) the size of the health and social impact of the health issue. A 9-cluster map of priority health and healthcare areas included: mental health and disability services; cost of health care; transport and technology challenges; mental health and related social issues; social determinants of health; availability of essential health services; quality and capacity of health services; health behaviours and environmental determinants; and cancer and respiratory health. Conclusion:Use of a structured, explicit approach to community and stakeholder consultation was highly feasible and effective in prioritising health issues. Translational impact/implications for future practice: These findings will inform development of ‘researchable’ topics that address the needs of rural and regional people. These prioritised health needs are informing the Grampians Health strategic agenda.